Role of manual small incision cataract surgery in <scp>A</scp>ustralia and developed nations

Gogate, Parikshit; Thomas, Ravi

doi:10.1111/ceo.12416

Cited by 3 publications

(2 citation statements)

References 11 publications

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“…Even in developed countries, SICS can be appropriate for dense cataracts where the posterior capsule cannot be seen, phacodonesis is very hard cataracts (as a high phaco power setting is needed) and for inexperienced surgeons. 32 …”

Section: Discussionmentioning

confidence: 99%

Meta-analysis to compare the safety and efficacy of manual small incision cataract surgery and phacoemulsification

Gogate

Optom

Deshpande³

et al. 2015

Middle East Afr J Ophthalmol

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Purpose:A systematic review and meta-analysis comparing the safety, efficacy, and expenses related to phacoemulsification versus manual small incision cataract surgery (SICS).Methods:PubMed, Cochrane, and Scopus databases were searched with key words manual SICS 6/18 and 6/60; astigmatism and endothelial cell loss postoperatively, intra- and post-operative complications, phacoemulsification, and comparison of SICS and phacoemulsification. Non-English language manuscripts and manuscripts not indexed in the three databases were also search for comparison of SICS with phacoemulsification. Data were compared between techniques for postoperative uncorrected and corrected distance visual acuity (UCVA and best corrected visual acuity [BCVA], respectively) better than 6/9, surgical cost and duration of surgery. The Oxford cataract treatment and evaluation team scores were used for grading intraoperative and postoperative complications, uncorrected near vision.Result:This review analyzed, 11 comparative studies documenting 76,838 eyes that had undergone cataract surgery considered for analysis. UCVA of 6/18 UCVA and 6/18 BCVA were comparable between techniques (P = 0.373 and P = 0.567, respectively). BCVA of 6/9 was comparable between techniques (P = 0.685). UCVA of 6/60 and 6/60 BCVA aided and unaided vision were comparable (P = 0.126 and P = 0.317, respectively). There was no statistical difference in: Endothelial cell loss during surgery (P = 0.298), intraoperative (P = 0.964) complications, and postoperative complications (P = 0.362). The phacoemulsification group had statistically significantly less astigmatism (P = 0.005) and more eyes with UCVA of 6/9 (P = 0.040). UCVA at near was statistically significantly better with SICS due to astigmatism and safer during the learning phase (P = 0.003). The average time for SICS was lower than phacoemulsification and cost <½ of phacoemulsification.Conclusion:The outcome of this meta-analysis indicated there is no difference between phacoemulsification and SICS for BCVA and UCVA of 6/18 and 6/60. Endothelial cell loss and intraoperative and postoperative complications were similar between procedures. SICS resulted in statistically greater astigmatism and UCVA of 6/9 or worse, however, near UCVA was better.

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Section: Discussionmentioning

confidence: 99%

Meta-analysis to compare the safety and efficacy of manual small incision cataract surgery and phacoemulsification

Gogate

Optom

Deshpande³

et al. 2015

Middle East Afr J Ophthalmol

Self Cite

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“…MSICS thus has a role for managing such cataracts even in developed countries. [ 9 ] Recent studies have shown that the needle-prick-free cataract surgery can also be done by SICS using the lying down looking down test. [ 10 ] Newer techniques of MSICS—as elucidated in this issue of the Indian Journal of Ophthalmology —promise better unaided distance and near vision.…”

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confidence: 99%

Relevance of manual small-incision surgery in today’s private practice setting

Gogate

2022

Indian Journal of Ophthalmology

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Impact of a formal manual small-incision cataract surgery curriculum in an American ophthalmology residency program

Ifantides

SooHoo

Christopher

2023

Indian Journal of Ophthalmology

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Purpose: Global ophthalmology educational activities often include the ability of ophthalmology residents to partake in low-resource clinical care at home and abroad. Low-resource surgical techniques have become a pillar of education during formalized global ophthalmology fellowships. A formal manual small-incision cataract surgery (MSICS) curriculum was started in the University of Colorado’s residency training program to meet the growing demand for this surgical skill and to allow for more sustainable outreach work from our graduates. The survey was conducted to collect evaluations on the value of formal MSICS training within a United States–based residency program. Methods: This was a survey study in a US ophthalmology residency program. A formal MSICS curriculum was created that included didactic lectures on epidemiology of global blindness, MSICS technique, and how MISCS compared to phacoemulsification in terms of cost and sustainability in low-resource settings, followed by a formal wet lab experience. Residents were then exposed to MSICS procedures in the operating room (OR) under supervision of an experienced MSICS surgeon. An anonymous online survey was conducted on three consecutive cohorts of recently graduated senior ophthalmology residents from 2019 to 2021 with the aim of eliciting opinions about and outcomes from the new curriculum. Results: Fifteen graduating senior residents comprised the three cohorts with a 100% survey response rate. All residents agreed or strongly agreed that “MSICS is a valuable skill to have”. Eighty percent of respondents agreed or strongly agreed that “exposure to MSICS has increased my likelihood of doing any type of outreach work in the future” and 86.67% agreed or strongly agreed that “exposure to MSICS increased my understanding about sustainable outreach work”. The average number of cases assisted or performed per resident was 8.2 (SD 2.7, range 4–12). Conclusion: A formal MSICS curriculum for US-based ophthalmology residents was well-received by the trainees. The majority felt it increased their likelihood of pursuing and improved their understanding of sustainable outreach work. The curriculum, which included lectures, wet lab training, and formal teaching in the OR, could add value to a residency program’s curriculum. Furthermore, a formal domestic program can avoid ethical pitfalls that can be seen with resident teaching during international mission work.

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Role of manual small incision cataract surgery in Australia and developed nations

Cited by 3 publications

References 11 publications

Meta-analysis to compare the safety and efficacy of manual small incision cataract surgery and phacoemulsification

Meta-analysis to compare the safety and efficacy of manual small incision cataract surgery and phacoemulsification

Relevance of manual small-incision surgery in today’s private practice setting

Impact of a formal manual small-incision cataract surgery curriculum in an American ophthalmology residency program

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